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lite.cnn.com - on gopher - inofficial
ARTICLE VIEW:
Opinion: What I didn’t know about my prostate almost killed me
Opinion by Ed Manning
Updated:
7:45 AM EDT, Wed April 17, 2024
Source: CNN
Recently, a misfiring prostate launched to the forefront of the
headlines, followed by the deaths of Dr. Martin Luther King Jr’s son,
, and from prostate cancer. While their celebrity status drove the
news, their underlying illnesses earned little more than a
parenthetical shrug. In the blink of a news cycle, prostate cancer was
again casually swept aside as .
Treatments are often downplayed as ” as if they were no more
consequential than a teeth cleaning. As a prostate cancer survivor, I
can report from painful experience that those misguided assessments are
to men’s health and longevity what ice was to the Titanic.
In the shadows of more celebrated organs afflicted by cancer, such as
the heart, pancreas, lungs and breasts, mentions of the prostate are
often waved off like the eccentric relative no one is comfortable
inviting to Thanksgiving. Most men’s knowledge of it extends no
further than those riveting seconds during an annual physical when the
doctor inserts their gloved finger into the patient’s rectum to feel
for abnormalities in the prostate. The exam isn’t a great
conversation starter, so few have much to say to the doctor once it’s
behind us. I wish I had, because if the prostate becomes cancerous, as
I and men found out in 2020, there is nothing physically or
psychologically minimal about it.
For context, the walnut-sized plays a pivotal role in the male
reproductive system. It is essential in producing seminal fluid and,
during sexual climax, its muscles contract, close off the opening
between the bladder and the urethra (there is no “p” in orgasm),
and forcefully release millions of stampeding sperm and fluids. It is
flanked by two neurovascular bundles that are to healthy sexual
function what Houston Control is to a shuttle launch. No nerve bundles
and the rocket sits lifeless on the pad. That positioning makes
treating the prostate complicated and lifts to the top of every man’s
prayers as he contemplates radiation, surgery or high-intensity focused
ultrasound (HIFU) treatments. As my wife told my surgeon as I shuffled
off to surgery, “Take all the time you need.”
Years leading up to my diagnosis, my doctors gave me two gloved thumbs
up after my digital viewing. “Looks great,” was the evaluation
through my 50s. As I cruised into my 60s, that was downgraded slightly
to “looks good,” with an aside that my prostate was slightly
enlarged.
“It’s typical of a man your age,” the doctors said. I had nothing
to worry about. I was athletic, plant-based, sun-screened, fully
flossed and free of trans fats, drugs, tobacco and asbestos. I should
have been a poster boy for cancer-free. Missing from that annual banter
and less-than-alarming prostate headlines were several . As the
American Cancer Society notes:
• Prostate cancer is the second leading cause of cancer death in
men.• One in eight will be diagnosed with it.• One in 44 will die
from it.
Another point my doctors failed to mention was that no matter how
thorough the annual digital screening, prostates can malfunction
without any such as a hardened or bumpy shell, blood in the urine, the
need to pee frequently or erectile dysfunction. Cancer can sneak its
way in undetected, and if not caught early, break free of the prostate
and run unchecked through the body with a particular penchant . For men
diagnosed with prostate cancer that to other parts of the body, the
5-year relative survival rate is only 32%.
Had I known any of those details, I would have kept a closer eye on
possible symptoms, nutritional recommendations and testing options. In
my case, it was a chance conversation with my wife that led to a
diagnosis.
“You are peeing differently,” she said. “That’s why I want you
to book your physical.” Getting directly to the heart of the matter,
I said, “You listen?” and then strategized about the best way to
immediately change the subject.
“The bathroom door isn’t soundproof,” she continued, “and it
sounds like things take longer to get going. You need to tell your
doctor. It could mean something.”
It did. What seemed trivial to me put my doctor on alert. He added a to
my bloodwork.
“Changes in the way you urinate is something you should have told
your previous doctor. Why didn’t you?” my doctor asked, adding a
reprimand on the tail end of his bad news. “And why didn’t you have
a PSA test before now? You could have caught this early.”
I explained that changes in peeing were gradual and inconsequential
enough to go unnoticed, like the frog in the heating pot of water.
Given my lack of knowledge of the prostate’s propensity to become
cancerous, I didn’t know what symptoms to look for. I assumed the
digital exam had me covered. I never had a PSA test, because none of my
previous doctors had ever ordered one. I never asked for one based on
the substantive difference between my BA in English Lit and a medical
degree.
A PSA test the presence of prostate-specific antigens in the blood that
can be indicative of cancer. In a perfect world, the score will ,
according to the National Cancer Institute. At age 62, my first ever
PSA score logged in at a harrowing 17. A biopsy confirmed somewhat
aggressive prostate cancer, a diagnosis which stunned and terrified me.
Six weeks later, after much research and deliberation, I underwent a
radical robotic nerve-sparing prostatectomy. That so-called minimally
invasive surgery took close to six hours and required multiple
incisions. Recovery involved one week with a catheter, a couple of
weeks of significant physical discomfort and three months before I was
able to tackle even a light workout.
Three years after my surgery, I am in remission and, by the grace of a
skilled surgeon and amazing advances in medicine, I don’t suffer the
dreaded side effects of incontinence or erectile dysfunction. But
technically, I’m not cured. Even after surgery, radiation or HIFU, is
not uncommon. Like most men , I take a blood test every six months, at
which point my anxiety skyrockets for the days it takes to get the
results confirming whether or not I’m cancer free.
While physicians assure me I will “probably die of something else,”
I wish that in addition to the cursory “looks good” I had heard
over the years, they had provided salient details about my prostate,
warning signs and testing options. While it’s too late for me to
catch my own cancer early, I encourage anyone with a prostate or anyone
who loves a person who has one to talk to a physician. Learn about
testing options and the importance of nutrition and staying active.
Understand the warning symptoms. Listen to your body or your
significant other who might be a better listener than you. What I
didn’t know almost killed me. If I had known what to listen for, my
former prostate and I might have happily grown old together.
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